11 至 12 岁人群接种人乳头瘤病毒疫苗后的性行为相关结局。

Sexual activity-related outcomes after human papillomavirus vaccination of 11- to 12-year-olds.

机构信息

Center for Health Research-Southeast, Kaiser Permanente, Atlanta, Georgia 30305, USA.

出版信息

Pediatrics. 2012 Nov;130(5):798-805. doi: 10.1542/peds.2012-1516. Epub 2012 Oct 15.

DOI:10.1542/peds.2012-1516

PMID:23071201

Abstract

OBJECTIVE

Previous surveys on hypothesized sexual activity changes after human papillomavirus (HPV) vaccination may be subject to self-response biases. To date, no studies measured clinical markers of sexual activity after HPV vaccination. This study evaluated sexual activity-related clinical outcomes after adolescent vaccination.

METHODS

We conducted a retrospective cohort study utilizing longitudinal electronic data from a large managed care organization. Girls enrolled in the managed care organization, aged 11 through 12 years between July 2006 and December 2007, were classified by adolescent vaccine (HPV; tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis, adsorbed; quadrivalent meningococcal conjugate) receipt. Outcomes (pregnancy/sexually transmitted infection testing or diagnosis; contraceptive counseling) were assessed through December 31, 2010, providing up to 3 years of follow-up. Incidence rate ratios comparing vaccination categories were estimated with multivariate Poisson regression, adjusting for health care-seeking behavior and demographic characteristics.

RESULTS

The cohort included 1398 girls (493 HPV vaccine-exposed; 905 HPV vaccine-unexposed). Risk of the composite outcome (any pregnancy/sexually transmitted infection testing or diagnosis or contraceptive counseling) was not significantly elevated in HPV vaccine-exposed girls relative to HPV vaccine-unexposed girls (adjusted incidence rate ratio: 1.29, 95% confidence interval [CI]: 0.92 to 1.80; incidence rate difference: 1.6/100 person-years; 95% CI: -0.03 to 3.24). Incidence rate difference for Chlamydia infection (0.06/100 person-years [95% CI: -0.30 to 0.18]) and pregnancy diagnoses (0.07/100 person-years [95% CI: -0.20 to 0.35]), indicating little clinically meaningful absolute risk differences.

CONCLUSIONS

HPV vaccination in the recommended ages was not associated with increased sexual activity-related outcome rates.

摘要

目的

之前关于人乳头瘤病毒（HPV）疫苗接种后假设性行为变化的调查可能受到自我反应偏差的影响。迄今为止，尚无研究测量 HPV 疫苗接种后的性行为临床指标。本研究评估了青少年接种疫苗后的性行为相关临床结局。

方法

我们利用大型管理式医疗组织的纵向电子数据进行了回顾性队列研究。在 2006 年 7 月至 2007 年 12 月期间，年龄在 11 至 12 岁之间的参加管理式医疗组织的女孩按青少年疫苗（HPV；破伤风类毒素、白喉类毒素和无细胞百日咳、吸附；四价脑膜炎球菌结合疫苗）接种情况进行分类。通过 2010 年 12 月 31 日评估结局（怀孕/性传播感染检测或诊断；避孕咨询），提供长达 3 年的随访。使用多变量泊松回归估计比较疫苗接种类别的发病率比，同时调整了寻求医疗服务的行为和人口统计学特征。

结果

该队列包括 1398 名女孩（493 名 HPV 疫苗暴露；905 名 HPV 疫苗未暴露）。与 HPV 疫苗未暴露的女孩相比，HPV 疫苗暴露的女孩发生复合结局（任何怀孕/性传播感染检测或诊断或避孕咨询）的风险没有显著升高（调整后的发病率比：1.29，95%置信区间[CI]：0.92 至 1.80；发病率差异：1.6/100 人年；95%CI：-0.03 至 3.24）。衣原体感染的发病率差异为 0.06/100 人年（95%CI：-0.30 至 0.18）和妊娠诊断的发病率差异为 0.07/100 人年（95%CI：-0.20 至 0.35），表明临床意义上的绝对风险差异很小。